Individual provider Active NPI

Angela Marie Godwin, N.P.

  • Nurse Practitioner
  • Bronx, NY
National Provider Identifier
1285838987
Registry record updated May 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
003941 Issued in CT
Practice address
1469 Astor Ave
Bronx, NY 10469-5846
Phone
(352) 281-4863
Fax
(347) 824-2978
NPI assigned
Jun 14, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F335139-1 NY
Nurse Practitioner 363L00000X 003941 CT Primary

Addresses

Primary practice location

1469 Astor Ave
Bronx, NY 10469-5846

Mailing address

12001 Avalon Lake Dr Apt 326
Orlando, FL 32828-7379
Phone (646) 457-8127

Other identifiers 10

IdentifierTypeStateIssuer
3V2401OtherCTHEALTH NET
203941OtherCTCONNECTICARE
06-1406459OtherCTTRICARE
06-1406459OtherCTGREAT WEST HEALTHCARE
06-1406459OtherCTCOMMUNITY HEALTH NETWORK
06-1406459OtherCTNORTHEAST HEALTH DIRECT
06-1406459OtherCTPIONEER
06-1406459OtherCTPRIVATE HEALTHCARE SYSTEMS
06-1406459OtherCTMULTIPLAN
400085656CT01OtherCTANTHEM BCBS ON CT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141112000126 NY Practitioner - Nurse Practitioner 3072673995 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Missouri, Columbia School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1469 Astor Ave
Bronx, NY 10469-5846
Phone (646) 457-8127

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
003941CTMDOccupational Therapist
F335139-1NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Angela M. Godwin, Nurse Practitioner in Family Health, PLLC. Family CurrentSince Jun 8, 2014 Accepting new patients

Locations

3626 E Tremont Ave
Ste 101
Bronx, NY 10465
Phone (718) 597-0100

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1181779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651449600000",
    "number": "1285838987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12001 AVALON LAKE DR APT 326",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328287379",
            "telephone_number": "646-457-8127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1469 ASTOR AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104695846",
            "telephone_number": "352-281-4863",
            "fax_number": "347-824-2978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GODWIN",
        "first_name": "ANGELA",
        "middle_name": "MARIE",
        "name_prefix": "Miss",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-14",
        "last_updated": "2022-05-02",
        "certification_date": "2022-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F335139-1",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CT",
            "license": "003941",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NET",
            "identifier": "3V2401",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICARE",
            "identifier": "203941",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "06-1406459",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GREAT WEST HEALTHCARE",
            "identifier": "06-1406459",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMUNITY HEALTH NETWORK",
            "identifier": "06-1406459",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NORTHEAST HEALTH DIRECT",
            "identifier": "06-1406459",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PIONEER",
            "identifier": "06-1406459",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIVATE HEALTHCARE SYSTEMS",
            "identifier": "06-1406459",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MULTIPLAN",
            "identifier": "06-1406459",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS ON CT",
            "identifier": "400085656CT01",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.